Kids' Diet Takes a Hit When Eating Out

Action Points

Explain that calculating nutrient consumption from NHANES data found increases in calorie, fat, sodium, and sugar in both children and adolescents eating in both fast-food and full-service restaurants.

Note that consumption of sugar-sweetened beverages and soda increased with restaurant eating in both children and adolescents while milk drinking decreased.

Children and teenagers consumed more calories with worse nutritional content when they ate at restaurants -- whether fast-food or full-service, a national survey suggested.

The increased daily caloric intake ranged from 126 to 309 kcal for younger children and adolescents. Regular intake of sugar-sweetened soda also increased daily caloric intake, according to Lisa M. Powell, PhD, and Binh T. Nguyen, MA, of the University of Illinois at Chicago.

Dining at fast-food and full-service restaurants was also associated with increased consumption of total dietary fat, saturated fat, and sugar, they reported online in Archives of Pediatric and Adolescent Medicine.

"The evidence clearly suggests that nonrestaurant caloric intake is not sufficiently reduced to compensate for additional calories obtained on days when consuming from restaurants," Powell and Nguyen wrote of their findings.

Noting that only two fast-food companies have membership in the Children's Food and Beverage Advertising Initiative, they concluded that "further consideration should be given to improve the initiative's nutritional guidelines and to apply it to adolescents."

Trends toward increased fast-food consumption have paralleled the rising prevalence and incidence of obesity in children and adolescents. Several studies have documented the association, but few studies have included full-service restaurants.

In an effort to broaden understanding of the association between consumption of restaurant food and childhood nutrition, investigators analyzed data from the 2003 to 2008 National Health and Nutrition Examination Survey (NHANES). They focused on households with children ages 2 to 11 and with adolescents ages 12 to 19. The analysis included 4,717 children and 4,699 adolescents.

Using dietary recall data from the NHANES surveys, investigators calculated daily total energy intake in kilocalories; grams of sugar, total fat, saturated fat, and protein; milligrams of sodium; and total grams of sugar-sweetened drinks, regular soda, and milk consumed.

The results showed that eating at fast-food restaurants was associated with increased total daily energy intake in children (126.29 kcal) and adolescents (309.53 kcal).

Dining at full-service restaurants was associated with increases of 160.49 kcal and 267.30 kcal for children and adolescents, respectively.

Dining at fast-food and full-service restaurants was associated with intake of sugar-sweetened beverages by children (91.41 and 143.97 g, respectively) and adolescents (162.40 and 126.10 g); general and regular soda (73.77 and 88.28 g for children, 163.67 and 107.25 g for adolescents); and reduced consumption of milk (30 g for children and 50 g for adolescents).

Eating at either type of restaurant was associated with higher intake of sugar (5.71 and 15.43 g), total fat (7.03 and 6.09 g), and saturated fat (1.99 and 1.52 g) by children. Full-service restaurant consumption was associated with increased sodium intake (225.71 mg) and protein intake (3.24 g).

The authors noted limitations of the study, including self-report of intake which tend to be underestimated, estimations of time-varying factors, and inability to distinguish which meals were being consumed in restaurants.

The study was supported by the National Cancer Institute and the Centers for Disease Control and Prevention.

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